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The need for lymph node dissection in nonmetastatic breast cancer.

Identifieur interne : 003065 ( Main/Exploration ); précédent : 003064; suivant : 003066

The need for lymph node dissection in nonmetastatic breast cancer.

Auteurs : Catherine Pesce [États-Unis] ; Monica Morrow

Source :

RBID : pubmed:23020881

Descripteurs français

English descriptors

Abstract

Determining whether cancer has spread to locoregional lymph nodes is a critical step in the initial staging of breast cancer patients. Although axillary dissection reliably identifies nodal metastases and prevents the recurrence of cancer in the axilla, there is a significant incidence of long-term side effects, notably lymphedema, and the procedure is of no therapeutic benefit in women without axillary metastases. With the advent of sentinel lymph node biopsy, the axilla can be accurately staged in patients with T1-T3, clinically node-negative breast cancers while avoiding the morbidity of axillary lymph node dissection if the nodes do not contain cancer. Recent clinical trials suggest that for women with metastases to 1 or 2 sentinel nodes, the radiation and systemic therapy that are part of modern multimodality breast cancer treatment can replace axillary dissection when breast-conserving therapy is undertaken. For those with greater disease burden or those undergoing mastectomy, axillary dissection remains standard management.

DOI: 10.1146/annurev-med-052511-135500
PubMed: 23020881


Affiliations:


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<term>Female</term>
<term>Humans</term>
<term>Lymph Node Excision (utilization)</term>
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<term>Aisselle</term>
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<term>Lymphadénectomie (utilisation)</term>
<term>Lymphoedème ()</term>
<term>Noeuds lymphatiques ()</term>
<term>Noeuds lymphatiques (anatomopathologie)</term>
<term>Tumeurs du sein ()</term>
<term>Tumeurs du sein (anatomopathologie)</term>
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<term>Noeuds lymphatiques</term>
<term>Tumeurs du sein</term>
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<term>Breast Neoplasms</term>
<term>Lymph Nodes</term>
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<term>Lymphedema</term>
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<term>Breast Neoplasms</term>
<term>Lymph Nodes</term>
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<div type="abstract" xml:lang="en">Determining whether cancer has spread to locoregional lymph nodes is a critical step in the initial staging of breast cancer patients. Although axillary dissection reliably identifies nodal metastases and prevents the recurrence of cancer in the axilla, there is a significant incidence of long-term side effects, notably lymphedema, and the procedure is of no therapeutic benefit in women without axillary metastases. With the advent of sentinel lymph node biopsy, the axilla can be accurately staged in patients with T1-T3, clinically node-negative breast cancers while avoiding the morbidity of axillary lymph node dissection if the nodes do not contain cancer. Recent clinical trials suggest that for women with metastases to 1 or 2 sentinel nodes, the radiation and systemic therapy that are part of modern multimodality breast cancer treatment can replace axillary dissection when breast-conserving therapy is undertaken. For those with greater disease burden or those undergoing mastectomy, axillary dissection remains standard management.</div>
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